DOM - Medicaid Program Nurse II
Mississippi Division of Medicaid - Mississippi

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The DOM-Medicaid Program Nurse II practices professional nursing under the direct or indirect supervision of the Medicaid Nurse Administrator or the DOM-Medicaid Nurse Bureau Director. The work includes case finding, health teaching, health counseling, assessment and evaluation of providers of services and related sites to ensure compliance with Medicaid Provider agreements, development, and review of Medicaid policies. Other duties include analyzing findings and recommending plans for correction to the providers. The incumbent may provide technical and programmatic guidance to nurses in the DOM-Medicaid Nurse I classification.

Examples of Work:
Examples of work performed in this classification include, but are not limited to, the following:

Reviews and studies federal and state laws, rules, and regulations governing agency's compliance.

Interprets and explains Medicaid regulations and guidelines to providers, beneficiaries, families, and other groups.

Conducts workshops and/or on-site training to providers of service in order to improve skills and knowledge of Medicaid rules and regulations.

Reviews and analyzes trends pertinent to delivery of services to Medicaid beneficiaries.

Develops and recommends new and revised policies, procedures, plans, and strategies to respond to changes in program needs, objectives, and priorities and to improve the effectiveness of services.

Provides assistance in developing and implementing policy and procedures for detecting fraud and abuse of program services, mis-utilization of services by providers and beneficiaries, and utilization reviews.

Reviews and audits records, charts, and reports to determine if correct and appropriate services were given.

Monitors and evaluates providers of service and related provider sites to beneficiaries in the Medicaid program.

Performs related or similar duties as required or assigned.

Minimum Qualifications:
These minimum qualifications have been agreed upon by Subject Matter Experts (SMEs) in this job class and are based upon a job analysis and the essential functions. However, if a candidate believes he/she is qualified for the job although he/she does not have the minimum qualifications set forth below, he/she may request special consideration through substitution of related education and experience, demonstrating the ability to perform the essential functions of the position. Any request to substitute related education or experience for minimum qualifications must be addressed to the State Personnel Board in writing, identifying the related education and experience which demonstrates the candidate's ability to perform all essential functions of the position.

EXPERIENCE/EDUCATIONAL REQUIREMENTS:
Education:
A Master's Degree in nursing;

AND

Experience:
Four (4) years of experience in nursing as a Registered Nurse/Nurse Practitioner and licensure as required below.

OR

Education:
Graduation from a state approved Nurse Practitioner program with credentials (certification);*

AND

Experience:
Four (4) years of experience in nursing as a Registered Nurse/Nurse Practitioner and licensure as required below.

OR

Education:
A Bachelor's Degree from an accredited four-year college or university in nursing;

AND

Experience:
Five (5) years of experience in nursing as a Registered Nurse/Nurse Practitioner and licensure as required below.

OR

Education:
Graduation from a three-year nursing program;

AND

Experience:
Six (6) years of experience in nursing as a Registered Nurse/Nurse Practitioner and licensure as required below.

OR

Education:
Graduation from a two-year Associate Degree nursing program;

AND

Experience:
Seven (7) years of experience in nursing as a Registered Nurse/Nurse Practitioner and licensure as required below.

OR

Experience:
Two (2) years as a DOM-Medicaid Program Nurse I.

Certification/Licensure Requirements:
Must have a valid license to practice as a Registered Nurse and/or Nurse Practitioner in the State of Mississippi.

  • Must possess approved certificate in area of practice.
Documentation Required:
Applicant must attach a valid copy of his/her license to practice as a Registered Nurse and/or Nurse Practitioner in the State of Mississippi.

Mississippi State Personnel Board - 2 years ago - save job
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